Abstract
Evaluation of viral myocarditis is essential for the clinician to assess the prognosis. In this study, Tl-201 myocardial scintigraphy and Tc-99m gated cardiac blood pool scan were performed in 16 patients with myocarditis diagnosed by clinical symptoms and laboratory findings and these nuclear medicine techniques were followed up for 5 years.
Exercise Tl-201 scintigraphy using a bicycle ergometer was performed in 8 patients by SPECT imaging. There were mild to severe persistent defects found in all cases (100%), but pressure rate products showed normal response. The Tl-201 defect ratio improved gradually, but did not change significantly. In the resting Tl-201 image one of 16 patients showed severe multifocal defects.
LVEF increased significantly from 1 year to 5 years after onset, while RVEF measured by gated blood pool scans showed slight increases 3 years to 5 years after diagnosis. It was concluded that myocardial perfusion improved only incompletely. Cardiac function (LVEF and RVEF) improved gradually, and pressure rate products were normal. Myocarditis should therefore be followed up in order to assess the prognosis; moreover, the relationship of myocarditis to dilated cardiomyopathy needs to be further studied.
Similar content being viewed by others
Abbreviations
- Tc-99m-PYP:
-
Tc-99m-pyrophosphate
- Tc-99m-RBC:
-
Tc-99m-red blood cell
- LVEF:
-
left ventricular ejection fraction
- RVEF:
-
right ventricular ejection fraction
References
Schachne JS, Stowers SA, Swett, JR DD, Alexander J: Thallium perfusion imaging in myocarditis.Connecticut Med 47: 759–761, 1983
Tamaki N, Yonekura Y, Kadota K, Kambara H, Torizuka K: Thallium-201 myocardial perfusion imaging in myocarditis.Clin Nucl Med 10: 562–566, 1985
Wells RG, Ruskin JA, Sty JR: Myocardial imaging Coxsackie myocarditis.Clin Nucl Med. 11: 661–662, 1986
Das SK, Brady TJ, Thrall JH, Pitt B: Cardiac function in patients with prior myocarditis.J Nucl Med 21: 689–693, 19qq
Ahmad M, Dubiel JP: Tc-99m pyrophosphate myocardial imaging in perimyocarditis.J Nucl Med 22: 452–454, 1981
Mitsutake A, Nakamura M, Inoh T, Kikuchi Y, Takeshita A, Fujimi S: Intense, persistent myocardial avid technetium-99m-pyrophosphate scintigraphy in acute myocarditis.Am Heart J 101: 683–684, 1981
Williamson MR, Williamson SL, Seibert JJ: Indium-111 leukocyte scanning localization for detecting early myocarditis in Kawasaki Disease.AJR 146: 255–256, 1986
O’Connell JB, Henkin RE, Robinson JA, Subramanian R, Scanlon PJ, Gunnar RM: Gallium-67 imaging in patients with dilated cardiomyopathy and biopsy-proven myocarditis.Circulation 70: 58–62, 1984
Jacobs JC, Rosen JM, Szen IS: Hyme myocarditis diagnosed by gallium scan.J Pediatrics 105: 950–952, 1984
Khaw BA, Yasuda T, Moore R, Gold HK, Fallon JT, Leinbach RC, Strauss HW, Haber E: In-111-monoclonal antimyosin and Tc-99m pyropshophate imaging in reflowed hearts.Circulation (Abstr) 70: 11–273, 1984
Take M, Sekiguchi M, Hiroe M, Hirosawa K: Long-term follow-up of electrocardiographic findings in patients with acute myocarditis proven by endomyocardial biopsy.Jpn Circ J 46: 1227–1234, 1982
Marquard C, Schamroth L: An electrocardiographic study of viral myocarditis.Heart & Lung 15: 208–210, 1986
Nieminen MS, Heikkila J, Karjalainen J: Echocardiography in acute infectious myocarditis.Am J Cardiol 53: 1331–1337, 1984
Weinhouse E, Wandermann K, Sofer S, Gussarsky Y, Gueron M: Viral myocarditis stimulating dilated cardiomyopathy in early childhood.Br Heart J 56: 94–97, 1986
Ikaheimo MJ, Takkuren JT: Echocardiography in acute infectious myocarditis.Chest 89: 100–102, 1986
Kondo M, Takahashi M, Shimono Y, Fujiwara H, Miyazaki S, Matsuda T: Reversible asymmetric septal hypertrophy in acute myocarditis.Jpn Circulation J 47: 1304–1309, 1983
Hayakawa M, Inoh T, Yokota Y, Kawanishi H, Matsumoto K, Kumaki T, Fukuzaki H: A long-term follow-up study of acute viral and idiopathic myocarditis.Jpn Circulation J 47: 1304–1309, 1983
Oda T, Hamamoto K, Morinaga H: Left ventricular hypertrophy in non-rheumatic myocarditis in children.Jpn Circulation J 46: 1235–1238, 1982
Hayakawa M, Inoh T, Yokota Y, Kawanishi H, Kumaki T, Takarada A, Seo T, Fukuzaki H: A long term follow up study of acute myocarditis an electro-cardiographic and echocardiographic study.Jpn Circulation J 48; 1362–1367, 1984
Liao PK, Seward JB, Hagler DJ, Driscoll DJ: Acute myocarditis associated with transient marked myocardial thickening and complete atrioventricular block.Clin Cardiol 7: 365–362, 1984
Woods JD, Nimmo MJ, Mackay-Scollay EM: Acute transmural myocardial infarction associated with active Coxsackie virus B infection.Amer Heart J 89: 283–287, 1975
Saffitz JE, Schwartz DJ, Southworth W, Murphree S, Rodriguez ER, Ferraris VJ, Roberts WC: Coxaackie viral myocarditis causing transmural right and left ventricular infarction without coronary narrowing.Am J Cardiol 52: 644–647, 1983
Kawai C: Idiopathic cardiomyopathy. A study on the infectious-immune theory as a cause of the disease.Jpn Circulation J 35: 765–770, 1971
Matsumori A, Kawai C: An experimental model for congestive heart failure after encephalomyocarditis virus myocarditis in mice.Circulation 65: 1230–1235, 1982
Zee-Cheng C-S, Tsai CC, Palmer DC, Codd JE, Pennington G, Williams GA: High incidence of myocarditis by endomyocardial biopsy in patients with idiopathic congestive cardiomyopathy.Am Coll Cardiol 3: 63–70, 1984
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kawamura, Y., Morishita, T., Yamazaki, J. et al. Evaluation of viral myocarditis in children by radionuclide method. Ann Nucl Med 4, 59–65 (1990). https://doi.org/10.1007/BF03164597
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03164597